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In order to be registered as a health practitioner in Australia, you must be able to demonstrate that your English language skills will enable you to safely practice your profession. The English language skills registration standard is one of the five core standards required under the National Law.

Initial registration means the first time that you apply for registration as a health practitioner in Australia.

You are also considered to be applying for initial registration if:

your registration has lapsed (or you are moving from non-practising registration to another registration type) and you have not used English as your primary language for more than five years, and you are now re-applying for registration, or

you currently hold or previously held limited registration and were granted an exemption from the English language registration standard under specified circumstances, and you are now applying for another type of registration.

If you grew up and completed all of your education in Australia, the most appropriate pathway for you is the combinedsecondary and tertiary education pathway. This pathway requires that at least two years of your secondary education as well as the qualification you are relying on for registration were taught and assessed in English in a recognised country (such as Australia). Although you may meet the standard through other pathways, it will be easiest for you to satisfy the evidence requirements (see evidence guide on the English language skills page on the AHPRA website) through this pathway.

If your qualification was taught and assessed in English, and English is your primary language, the primary language pathway is the most appropriate for you.

This pathway requires that English is your primary language (that is, the language you use most frequently and are most familiar and comfortable with), that you completed all of your primary and secondary education in English in a recognised country (such as Australia) and that the qualification you are relying on for registration was taught and assessed in English. However, this qualification does not need to have been obtained in a recognised country.

If your qualification as a health practitioner was not taught and assessed in English, you will need to demonstrate that you meet the standard through the English language test pathway.

If you have completed at least six years (full-time equivalent) continuous education in English, including your relevant health qualification, in a recognised country, you meet the standard through the extended education pathway.

If your qualification as a health practitioner was not taught and assessed in English, you will need to demonstrate that you meet the standard through the English language test pathway.

The information you provide in your application for registration about your English language skills may be checked by AHPRA. However, it is up to you to ensure that you maintain your level of English language proficiency once you are registered, even if you frequently communicate with patients in a language other than English.

The National Boards and AHPRA may also reassess your English language skills if specific concerns arise, e.g. if a complaint is made about you.

The recognised countries are: Australia, United States, United Kingdom, Canada, New Zealand, the Republic of Ireland and South Africa. With the exception of South Africa and Australia, these countries are the same as the countries recognised by the Department of Immigration and Border Protection (DIBP) for the purpose of exempting visa applicants from having to sit a test to demonstrate English language competency.

This approach reflects similar approaches taken by state and territory health practitioner boards in Australia before the National Scheme commenced, as well as National Boards' experience since the National Scheme started. The recognised countries have health care delivery systems with significant similarities to Australia. In most of these countries, health care is almost always delivered in English.

South Africa is included in the list of ‘recognised countries’ in the standard, consistent with the approach taken by a number of Australian health practitioner regulators before the National Scheme started. In developing the current standard, National Boards consulted on whether South Africa should be removed from the list, bringing it into line with DIBP. After considering the available evidence, National Boards decided that South Africa should remain on the list of recognised countries for the time being.

The English language skills registration standard applies to all applicants for initial registration as a health practitioner in Australia. This means that all new applicants for registration must meet the standard, regardless of their language background or visa status.

The standard aligns closely with the Department of Immigration and Border Protection (DIBP) English language requirements for skilled migration visas. The four tests listed in the new standard – IELTS Academic, OET, TOEFL iBT and PTE Academic – are also used by DIBP to assess English language competence. If you sat one of these tests as part of your application for a skilled migration visa in the past two years and you achieved the results specified in the standard, you can use those results and do not need to sit another test.

Note that the Cambridge English: Advanced (CAE) test is accepted by DIBP but is not currently accepted by National Boards.

The new English language skills registration standard has been developed to ensure that the high level of English language skill expected of registered health practitioners in Australia is maintained. However, additional pathways have been added to ensure that applicants who demonstrably meet the standard are not disadvantaged due to their particular circumstances. The new standard also includes two new English language tests, giving applicants greater choice in how they demonstrate that they meet the standard through the English language test pathway. Increasing the number of test sittings from which results can be counted in certain circumstances also provides reasonable flexibility for applicants, without altering the level of English language competence required in order to meet the standard.

English language tests

The tests used by the National Boards to determine English language competence are also used by the Department of Immigration and Border Protection (DIBP) to determine visa eligibility. The scores required to demonstrate English language competence for each test are specified in the standard. Each test is slightly different, however the scores required to meet the standard have been benchmarked so they are set at equivalent levels across all the tests. It is not easier to achieve the required scores on one test, compared with any of the others.

The IELTS, PTE Academic and TOEFL iBT test can be taken by applicants from any profession. Currently, the OET test is not applicable for chiropractic, osteopathy and psychology applicants for registration, as OET has not yet developed a specific test for these professions. For Chinese medicine, any of the existing OET tests will be accepted as evidence.

In choosing which test to sit, you will need to do your own research and decide on which test is the most suitable or convenient for you. Links to the tests are published on the English language skills page on the AHPRA website.

International medical graduates may also rely on their results of the NZREX clinical exam (NZ) or Professional and Linguistic Assessments Board (PLAB) test (UK). For further information, see FAQs medicine below.

There is no change to the test result requirements for OET – a minimum score of B in all components is still required.
For other tests, there are several key differences:

IELTS – The new standard requires a score of 7 in each component and an overall score of 7. This is different from the old Chinese medicine standard, which required a score of not less than 6.5 in any component and an overall score of 7. The old Chinese medicine standard also included a temporary arrangement for ‘grandparenting’ which allowed for a test result of 6.0 in certain circumstance. After 1 July 2015, this will no longer apply.

TOEFL – This test is not accepted any more. Instead, applicants can choose to take the TOEFL iBT. The minimum scores for this test are outlined in the standard.

An additional test has also been added, the PTE Academic. The minimum scores for this test are outlined in the standard.

In addition to the above changes, the new standard gives applicants the option of submitting test results from up to two test sittings in a six month period in order to achieve the required results in all components, as long as certain minimum scores are maintained. This provides additional flexibility for applicants who must demonstrate that they meet the standard through the English language test pathway.

Ideally, you will be able to demonstrate that you meet the standard in one test sitting. However, National Boards will accept results from a maximum of two test sittings in a six month period so long as certain minimum scores are achieved in each sitting. These vary from test to test and are outlined in the standard. Note that this does not mean that you can only sit the test twice in the six month period; you may sit the test more than twice if you wish (although this is not recommended by the testing authorities). However, only the results from two sittings will be considered by National Boards.

However there are certain circumstances in which you may not have to sit another test. If, within twelve months of sitting the test, you started or continued employment as a registered health practitioner in one of the recognised countries where English was the primary language of practice; or you commenced or continued your enrolment in a Board approved program of study and you applied for registration within 12 months of completing that employment or study, you may not have to sit another test. Each application will be assessed to ensure that the employment or study undertaken satisfies the requirements specified in the standard.

For further information on the evidence you will need to verify your test result and your period of employment or study, please see the English language skills registration standard evidence guide published on the English language skills page on the AHPRA website.

If the two tests were taken within a six month period, and the first test was taken less than two years ago, then it is possible that you now meet the standard. Your results will need to be assessed to ensure that they meet all the criteria for multiple test sittings specified in the standard. You should contact AHPRA to check the status of your application.

Evidence requirements

The evidence required to demonstrate secondary education taught and assessed in English in one of the seven recognised countries listed in the standard may vary, depending on where it occurred.

For detailed information about the evidence you need to provide, please see the English language skills registration standard evidence guide published on the English language skills page on the AHPRA website.

The evidence required to demonstrate tertiary education taught and assessed in English in one of the seven recognised countries listed in the standard may vary, depending on where it occurred.

For detailed information about the evidence you need to provide, please see the English language skills registration standard evidence guide published on the English language skills page on the AHPRA website.

You should provide as much information as possible in the application form. AHPRA will consider whether the information you have provided is sufficient evidence of meeting the standard. If not, you may need to sit an English language test.

a course load that a student would need to take in order to complete a course in the minimum time (not including accelerated or fast-track courses). For example, a full-time load for a four year undergraduate degree would be the normal course load for a student who would expect to complete that degree in four years, or

a combination of part-time courses, which together make up a full-time course load. For example, two part-time courses taken at the same time, each consisting of a 50% course load.

Course loads for particular programs of study are set by educational institutions.

If your course load is greater than full-time, you cannot count the additional study towards the total number of years you are claiming. For example, if you are undertaking full-time study for a particular course, but are also studying another course part-time, you cannot claim the equivalent of 1.5 times the duration of study in English. That is, one year of full-time equivalent study is the maximum that you can claim in a single year, regardless of whether your subject load would normally be considered to be in excess of full-time.

You can count part-time studies as long as your overall course load is full-time equivalent. For example, you may be studying one part-time course with a 40% course load and another part-time course with a 60% course load. Together, this would be considered a full-time equivalent course load.

Any period of leave within the 6 years extended education that is not an education institution’s scheduled holiday, eg for overseas travel or maternity leave, means that the 6 years is not continuous as required by the English language skills registration standard. The best option in this situation is to use the English language test pathway, which is intended for applicants who cannot meet the other pathways in the standard and is not affected by gaps in education or employment.

Yes, as long as your overall course load is full-time equivalent and it meets the requirements in the definition for vocational education. Please see the English language skills registration standard evidence guide for the definition for vocational education.

Yes, you may be able to include this course if it meets the requirements in the definition for vocational education. The length of time you may count towards the required number of years of study in English will depend on whether you studied full-time or part-time. If you studied part-time, you can only count this course if you were studying another course part-time (that also meets the requirements in the definition), such that your total hours of study in English would be considered ‘full-time equivalent’.

Potentially. You can count online study provided that the course requires you to use English language speaking, writing, reading and listening skills. Courses that are delivered entirely online and do not require students to use all these English language skills to communicate are not acceptable. For vocational education, the course must also meet the requirements in the definition for vocational education. You may be required to provide further evidence about the program and delivery method.

It is unlikely. Traineeships and apprenticeships generally involve full time work and on the job training by an employer, which is supplemented by some formal education with a Registered Training Organisation, whereas the extended education pathway considers a full time course of study that is formally assessed. For example, a Pharmacy intern training program will not be accepted as vocational education under the extended education pathway.

English language registration conditions

If you continue to renew your registration each year, nothing happens. You must continue to comply with any conditions on your registration. If you have evidence that you now meet the English language skills registration standard, you can apply to have the conditions removed. After 1 July 2015, this evidence will be assessed against the new Common English language skills registration standard.

If your registration lapses and you reapply for registration, your English language skills will be assessed against the new standard.

Yes. You may apply at any time for an English language condition to be removed if there has been a material change in circumstances (for example, you have a new English language test result which demonstrates that you now meet the English language standard through the English language test pathway).

If required by the conditions on your registration, you must use a suitable language interpreter to help you communicate safely and effectively with patients.

This condition only applies when you and your patient do not share a common language. In these cases, a suitable interpreter must be used. A suitable interpreter is an adult who:

has experience in health interpreting

is agreed to by both the patient and the practitioner

is considered by both the patient and the practitioner to be competent in communicating in their respective languages, and

agrees not to compromise privacy and confidentiality.

The Chinese Medicine Board (the Board) will not direct you to use a specific interpreter. However, the Board may inquire into the arrangements you have in place if a complaint is made about you which may relate to your English language skills.

In selecting an interpreter, you should choose someone who can communicate effectively with your patient in their language, based on your professional judgment. Your primary consideration must be the safety and wellbeing of your patients.

If the patient agrees, it may be appropriate for a friend or family member of the patient to act as an interpreter.

Information about interpreter services is available from the Australian Government Department of Immigration and Border protection (DIBP). The DIBP’s Translating and Interpreting Service (TIS) National can be contacted on 131 450, or via their website.

If required by the conditions on your registration, a person who has sufficient English language skills to communicate swiftly and effectively in English with emergency services must be present on the premises at all times when treatments are undertaken. This may be you or another person.

If you are not confident of your ability to communicate swiftly and effectively in English, then another person with adequate English to communicate with emergency services should be present on the premises.

You need to exercise your own professional judgment in deciding whether your ability to communicate in English, in the circumstances of an emergency, is sufficient to communicate effectively with emergency services. Your primary consideration should be the safety and wellbeing of your patients. The Board may inquire into the arrangements you have in place in your practice.

Even if there are conditions on your registration, you may still be able to treat English-speaking patients. If you are confident that you and your patient share a common language, you may do so without an interpreter.

A common language is one in which you:

can competently communicate for the purpose of practising Chinese medicine

If you do not share a common language, a suitable interpreter must be used. A suitable interpreter is an adult who:

has experience in health interpreting

is agreed to by both the patient and the practitioner

is considered by both the patient and the practitioner to be competent in communicating in their respective languages, and

agrees not to compromise privacy and confidentiality.

The interpreter may be someone that the patient provides, for example, a family member or friend provided all the above points are met or someone from a professional interpreter service. You are accountable for your practice and need to make a sincere, professional judgment about the adequacy of your arrangements to protect the safety and wellbeing of your patients.

If a complaint is made about you which may relate to these conditions or to your English language skills in general, you may be asked by the Board to justify your arrangements.

If you are currently registered, you do not have to demonstrate that you meet the English language skills registration standard. However, you are still bound by the undertaking you gave when you registered in Victoria to comply with the effective communication guidelines. You were required to sign a statutory declaration agreeing to implement suitable arrangements (such as using interpreters where necessary). This is still binding.

If you become de-registered (for example, if you do not renew your registration), you will have to apply again and will be required to meet the English language skills registration standard, including any evidence requirements.

If you continue to maintain your registration, you will not be required to provide evidence that you meet the standard.

One of the primary objectives of the National Scheme is to protect public safety.

Conditions allow National Boards to maintain a balance between the interests of public safety and the workforce considerations of the National Scheme, by allowing practitioners to continue to practise while improving their qualifications or ability to meet the required standards. Conditions are not punitive and are only imposed when necessary to support the practitioner and to protect the public.